The Forty-sixth Meeting of the World Health Organisation (WHO)’s Expert Committee on Drug Dependence (ECDD) was convened from 16 to 19 October 2023 and was coordinated from the WHO headquarters in Geneva. The Forty-sixth WHO ECDD critically reviewed six new psychoactive substances: including two benzodiazepines (bromazolam, flubromazepam), one novel synthetic opioid (butonitazene), two cathinones/stimulants (3-CMC, dipentylone) and one dissociative-type substance (2-fluorodeschloroketamine). A critical review to consider international scheduling measures was undertaken for each substance so that the Expert Committee could consider whether information about these substances may justify the scheduling or a change in scheduling of a substance in the 1961 or 1971 Conventions. In addition, the Forty-sixth ECDD carried out a pre-review of nitrous oxide and carisoprodol to consider whether current information justified a critical review. This report summarizes the findings of the forty-sixth ECDD meeting.

"These guidelines were produced by the World Health Organization (WHO), Department of Mental Health and Substance Abuse, in collaboration with the United Nations Office on Drugs and Crime (UNODC) a Guidelines Development Group of technical experts, and in consultation with the International Narcotics Control Board (INCB) secretariat and other WHO departments. WHO also wishes to acknowledge the financial contribution of UNODC and the Joint United Nations Programme on HIV/AIDS (UNAIDS) to this project. " - p. iv

This report presents the recommendations of the WHO Expert Committee responsible for reviewing information on dependence-producing drugs, in order to assess the need for their international control. It describes the review procedures for dependence-producing substances, and considers the problems of terminology used in reporting abuse-related adverse drug reactions. It provides a critical evaluation of five psychoactive substances, as well as discussing six others, four of which were recommended for review at a future meeting.

This report presents the recommendations of the WHO Expert Committee responsible for updating the WHO Model List of Essential Medicines. The first part contains a progress report on the new procedures for updating the Model List and the development of the WHO Essential Medicines Library. It continues with a section on changes made in revising the Model List followed by a review of some sections such as hypertensive medicines and fast track procedures for deleting items. Annexes include the 13th version of the Model List and items on the list sorted according to their 5-level Anatomical Therapeutic Chemical classification codes.

The WHO Expert Committee on Drug Dependence (ECDD) is responsible for assessing psychoactive substances for possible control under the international drug control conventions. The ECDD reviews the therapeutic usefulness, the liability for abuse and dependence, and the public health and social harm potential of each substance under review. After the ECDD advises the Director-General of WHO as to whether to schedule or to amend the scheduling status of a substance, the Director-General will, as appropriate, communicate the recommendations to the United Nations Secretary-General. The Secretary-General communicates the advice to the Commission on Narcotic Drugs (CND), as appropriate. This report presents the recommendations of the thirty-seventh meeting of the WHO Expert Committee on Drug Dependence. The report summarizes the review of nine substances and the ECDD's recommendations for the scheduling of seven substances. The report also provides updates on ketamine and cannabis, as requested by resolutions of the Commission on Narcotic Drugs. It contains updates on the work of international bodies concerned with controlled substances, as well as summaries of the follow-up discussions on recommendations made at the previous ECDD meeting, and on the discussions on criteria for assessing new psychoactive substances and on terminology.

The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.